Manitoba Hansard — 22 October 2015 (Sitting 70B, 40th Legislature, 4th Session)

40-4-70b

Manitoba — Debates (Hansard)

Fourth Session - Fortieth Legislature of the Legislative Assembly of Manitoba DEBATES and PROCEEDINGS Official Report (Hansard) Published under the authority of The Honourable Daryl Reid Speaker Vol. LXVII No. 70B - 1:30 p.m., Thursday, October 22, 2015 ISSN 0542-5492

MANITOBA LEGISLATIVE ASSEMBLY Fortieth Legislature Member Constituency Political Affiliation ALLAN, Nancy St. Vital NDP ALLUM, James, Hon. Fort Garry-Riverview NDP ALTEMEYER, Rob Wolseley NDP ASHTON, Steve, Hon. Thompson NDP BLADY, Sharon, Hon. Kirkfield Park NDP BRAUN, Erna, Hon. Rossmere NDP BRIESE, Stuart Agassiz PC CALDWELL, Drew, Hon. Brandon East NDP CHIEF, Kevin, Hon. Point Douglas NDP CHOMIAK, Dave, Hon. Kildonan NDP CROTHERS, Deanne, Hon. St. James NDP CULLEN, Cliff Spruce Woods PC DEWAR, Greg, Hon.

Selkirk NDP DRIEDGER, Myrna Charleswood PC EICHLER, Ralph Lakeside PC EWASKO, Wayne Lac du Bonnet PC FRIESEN, Cameron Morden-Winkler PC GAUDREAU, Dave St. Norbert NDP GERRARD, Jon, Hon. River Heights Liberal GOERTZEN, Kelvin Steinbach PC GRAYDON, Cliff Emerson PC HELWER, Reg Brandon West PC HOWARD, Jennifer Fort Rouge NDP IRVIN-ROSS, Kerri, Hon. Fort Richmond NDP JHA, Bidhu Radisson NDP KOSTYSHYN, Ron, Hon. Swan River NDP LATHLIN, Amanda The Pas NDP LEMIEUX, Ron, Hon. Dawson Trail NDP MACKINTOSH, Gord, Hon. St. Johns NDP MALOWAY, Jim Elmwood NDP MARCELINO, Flor, Hon.

Logan NDP MARCELINO, Ted Tyndall Park NDP MARTIN, Shannon Morris PC MELNICK, Christine Riel NDP MITCHELSON, Bonnie River East PC NEVAKSHONOFF, Thomas, Hon. Interlake NDP OSWALD, Theresa Seine River NDP PALLISTER, Brian Fort Whyte PC PEDERSEN, Blaine Midland PC PETTERSEN, Clarence Flin Flon NDP PIWNIUK, Doyle Arthur-Virden PC REID, Daryl, Hon. Transcona NDP ROBINSON, Eric, Hon. Kewatinook NDP RONDEAU, Jim Assiniboia NDP ROWAT, Leanne Riding Mountain PC SARAN, Mohinder, Hon. The Maples NDP SCHULER, Ron St. Paul PC SELINGER, Greg, Hon. St.

Boniface NDP SMOOK, Dennis La Verendrye PC STEFANSON, Heather Tuxedo PC STRUTHERS, Stan Dauphin NDP SWAN, Andrew Minto NDP WIEBE, Matt Concordia NDP WIGHT, Melanie, Hon. Burrows NDP WISHART, Ian Portage la Prairie PC Vacant Gimli – Vacant Southdale –

2441 LEGISLATIVE ASSEMBLY OF MANITOBA Thursday, October 22, 2015 The House met at 1:30 p.m. Mr. Speaker: Good afternoon, everyone . Please be seated. ROUTINE PROCEEDINGS INTRODUCTION OF BILLS Bill 45–The Elections Amendment Act Hon. Dave Chomiak (Minister of Mineral Resources): Mr. Speaker, I move, seconded by the Minister of Finance (Mr. Dewar), that Bill 45, The Elections Amendment Act; Loi modifiant la Loi électorale, be now read a first time. Motion presented. Mr. Chomiak: Mr.

Speaker, Bill 45 amends The Elections Act following recommendations from Elections Manitoba to move towards the creation of a permanent voters list. The bill will allow Elections Manitoba enumerators to do an enhanced enum - eration, and the 2016 genera l election is part of that work. I appreciate the support of the Opposition House Leader and the member for River Heights (Mr. Gerrard) with the introduction of this act. Mr. Speaker: Is it the pleasure of the House to adopt the motion? [Agreed] Any further introduction of bills? Seeing none, we'll move on to committee reports. Tabling of reports?

Ministerial statements? MEMBERS' STATEMENTS Corporal Nathan Cirillo Mr. Andrew Swan (Minto): One year ago today, Corporal Nathan Frank Cirillo was shot and killed at the young age of 25. Any death of a military member is tragic, but the horror of this event was intensified by the fact that Corporal Cirillo was not deployed overseas. Rather, he stood on duty, unarmed, at Ottawa's National War Memorial. Corporal Cirillo was a reservist with plans to join the regular force. He grew up in Hamilton, Ontario, and joined the Argyll and Sutherland Highlanders infantry unit as soon as he could.

Corporal Cirillo was a father, son and a brother. Looking back, we once more offer our condolences to his family for their loss, honour his memory and thank all those brave people who don a uniform to protect Canadian lives. I stand today to thank our Canadian military personnel in the regular forces and the reserves across Manitoba, including those stationed at Minto Armouries on St. Matthews Avenue. We cannot underestimate the value of their contributions to our security.

The reservist infantry soldiers based at Minto Armouries, like others across our country, mirror t he valour and dignity displayed by Corporal Cirillo, serving and protecting us, but also serving as community leaders, coaches and volunteers. They're our family, our friends and our neighbours. The courage required to join the military is something that few have, and yet it is imperative for the safety of our country. When our military personnel go to work, they know they may be called upon to make the ultimate sacrifice, which is exactly what Corporal Cirillo did.

The motto of Corporal Cirillo's unit is Ne Obliviscaris, Sans Peur: Do not Forget, Without Fear. Corporal Cirillo fulfilled that motto. We will not forget him. Corporal Nathan Cirillo and Warrant Officer Patrice Vincent Mr. Reg Helwer (Brandon West): Mr. Speaker, I rise today to mark the sad anniversary of the death of two soldiers on Canadian soil. Corporal Nathan Cirillo was killed while standing guard at our National War Memorial in Ottawa. Warrant officer Patrice Vincent was killed in a hit -and-run in Saint-Jean-sur-Richelieu, Quebec.

Both were targets of extremists, and many observers say that with their deaths Canada has lost its innocence. Mr. Speaker, in my previous career, I have been in Ottawa many times and I've walked down the hallway to th e Library of Parliament. That was the hallway where sergeant -at-arms Kevin Vickers bravely ended the assault on Parliament. Mr. Speaker, I was in Ottawa last spring at a Commonwealth Parliamentary Association

2442 LEGISLATIVE ASSEMBLY OF MANITOBA October 22, 2015 conference, and again walked down that hallway and saw the damage that was done by the assaults. I was somewhat surprised that legislators from other Commonwealth countries not only knew of the assault, but were also concerned about the well-being of Canadians. Mr. Speaker, on a cold April night this year, I spent some time at the National War Memorial, and it seemed to be a far different place than past visits. There were many other people there, and I watched as they approached the memorial to give their respects.

I am sure their thoughts were similar to mine: great sadness at lives cut short, honouring those who have given their lives to ensure our freedom that we sometimes take for granted. Mr. Speaker, this morning at the war memorial there was a commemoration ceremony honouring Corporal Nathan Cirillo and Warrant Officer Patrice Vincent. Mr. Speaker, I ask leave for a moment of silence for the members of the Legislative Assembly of Manitoba to honour those two members of our Canadian military. Mr. Speaker: Is there leave of the Hous e to observe a moment of silence? [Agreed] Please rise.

A moment of silence was observed. Investing in École La Vérendrye Ms. Jennifer Howard (Fort Rouge): Joining us in the gallery today are Claudette Warnke, principal of École La Vérendrye, and parents of La Vérendrye students Stacy Huard, Denise Clarke and Salena Buchan. Having recently sent my own child off to school for the first time, I know that all parents want their kids to get the best possible start in life. I am confident and thankful that our teachers, staff and parents work hard to help our kids thrive.

Our government is supporting their hard work by investing $5 million in a new gymnasium and new classrooms for students at École La Vérendrye. By the next school year, these kids will have more room to play and learn. I was honoured to take

part in the sod- turning ceremony at École La Vérendrye. With some fantastic singing from the kids, this ceremony highlighted our investment and the partnership with the City of Winnipeg and Winnipeg School Division. And we thanked the parents, alumni and others who have worked hard to raise money and plan for the best use of these new facilities. The parent council started with a modest goal of raising a few thousand dollars; they raised more than $200,000. This funding will make the new gym a place that the whole neighbourhood can enjoy. Our government has made a choice to build instead of cut.

Since for ming government, we have more than tripled our capital investments into public schools. We've invested over $1.4 billion to build and maintain schools throughout Manitoba, including 35 new and replacement schools and 82 major additions like the new gym and classrooms for École La Vérendrye. And we chose to hire more teachers, the most important investment in any classroom. Looking at the faces of those singing kids at La Vérendrye, and watching my own children learn and grow, I know we made the right choice. Thank you. Manitoba Hydro Bipole III Costs Mr.

Ralph Eichler (Lakeside): I stand today before this Assembly to speak about Hydro. Prior to 1999, Manitoba Hydro had been the crown jewel of Manitoba. Manitobans enjoyed some of the lowest rates in North America. That has changed, Mr. Speaker. We are no longer the powerhouse of low energy rates. This government has interfered in the management of Manitoba Hydro. Manitoba Hydro made the decision to take Bipole III down the east side of Lake Winnipeg at a cost of $1 billion.

Our NDP government then decided that it would change that line to the west side, some 400 kilometres further, at a much higher cost estimated to be $4.6 billion. We all know that cost estimates of past projects have been way over budget estimates. This project is going right through some of the best farmland in this province. This is the first time the people of Manitoba, the real owners of Manitoba Hydro, had to expropriate property for any project. * (13:40) Line loss is a large factor in addition to the extra $3.6 billion in cost.

To make matters worse, every member opposite went door to door and told all Manitobans the cost of Bipole III would not cost them a cent; the cost of Bipole III would be included

October 22, 2015 LEGISLATIVE ASSEMBLY OF MANITOBA 2443 in the price of hydro sold to our American neighbours. We find out this was not the case at all. The real owners of Manitoba Hydro, the people of Manitoba, would pick up the total cost of Bipole III. Therefore, Mr. Speaker, we on this side of the House, what we've been asking for is very clear. We want the NDP to respect the real owners of Manitoba Hydro, the people of Manitoba Hydro, and listen to Hydro's experts in taking technical hydro. David Collins Memorial Cairn Mr.

Clarence Pettersen (Flin Flon): History is always being revised, and sometimes even stories we are told as children can suddenly become a part of history. Historians say things like, if s tones could talk. Well, sometimes, Mr. Speaker, they do. Emilia McNichol told her granddaughter Kelleen Blouin a story about some stones. In that story her old grandfather, a Metis trapper named David Collins, showed a prospector named Tom Creighton some stones. Those stones were the mineral deposit that gave birth to the town of Flin Flon and one of the greatest mines in Canadian history.

In today's coin it yielded up metals worth $14 billion, giving generation upon generation of people a wonderful plac e to live, work and play. Tom Creighton staked the claim on those stones and enjoyed the wealth that followed. The town of Creighton, a stone's throw from Flin Flon, was named after him. David Collins received some $6 worth of flour, lard and tea for showing Tom Creighton those stones. On September 27th of this year, I stood amongst the people, including many of David Collins' descendants who fought to get Mr. Collins the recognition he deserves.

Thanks to efforts of a committee dedicated to bringing an historical truth to light, a cairn to David Collins' legacy now stands in the neighbourhoods of the North Park. Kelleen Blouin spoke at the unveiling, citing another story her grandfather told her. Collins used to joke that he was still waiting for my su gar to put in my tea that Creighton promised me. And so to recognize the sweetness of the historical truth, she poured a bit of sugar on the cairn.

Thanks to the perseverance of Collins' des - cendants and the tireless advocacy of Gerry Clark and his commit tee, a beautiful stone now stands commemorating the historical truth: Flin Flon's history started with the help of a Metis trapper named David Collins. It continues because Flin Flon cares about the history and their heritage. Thank you, Mr. Speaker. Mr. Speaker: That concludes members' statements. Introduction of Guests Mr. Speaker: And just prior to oral questions, I have some guests to introduce.

Seated in our public gallery we have with us this afternoon from Neil Campbell School, we have 48 grade 4 students under the direction of Mr. Alvin Dyck, and this group is located in the constituency of the honourable member for Elmwood (Mr. Maloway). On behalf of all honourable members, we welcome you here this afternoon. And it is our practice to introd uce our new pages. I'd like to introduce our new page who is with us here this afternoon and joining us for this session, Shivani Hunter, who is a student at St. Mary's Academy.

On behalf of all honourable members, we welcome you here to the Legislative A ssembly and wish you well in your Legislative Assembly work. Thank you very much for your service to the members of the Assembly. ORAL QUESTIONS Provincial Deficit Cost to Manitobans Mr. Brian Pallister (Leader of the Official Opposition): A little over a year ago a respected international bond rating firm, Moody's international, issued a warning to the government in respect of their management practices. The warning was clear and it was explicit, and it made comments in respect of the fiscal mismanagement that had occurred.

It referenced overspending and wasteful spending practices, and it gave a heads -up to anyone who chose to read the warning. Unfortunately, the Premier apparently did not or his Cabinet members did not read the warning. They were war ned and they went ahead and produced a budget, and the budget they produced disregarded every piece of advice they'd received not only from Moody's but from us, from other Manitobans around the province. And it raised the projections on the deficit by over 20 per cent year over year and it

2444 LEGISLATIVE ASSEMBLY OF MANITOBA October 22, 2015 raided the rainy day fund and it borrowed, it borrowed, it borrowed from our future and our children's future to spend today. The result was the first downgrade of our credit rating in 30 years. I want to ask the Premier : What is the annual cost to Manitobans? What is the loss as a result of his refusal to listen? Hon. Greg Selinger (Premier): I thank the member for the question. The–he may know that the actual interest rate for the Bank of Canada went down. Our budge t projects that the debt servicing costs are lower this year than last year.

Under the member opposite when he was in government they paid over 13 cents on every dollar for debt relief. Under us we are down to, this year, to 5.6 cents on the dollar, ove r 58 per cent lower costs for servicing the debt. We're building schools. We're building roads. We're building personal -care homes. We're creating 50–nearly 60,000 jobs over the next five years. We created close to 10,000 jobs this year, Mr. Speaker. We're building the infrastructure that Manitobans have told us is a priority. We're doing it at low borrowing costs.

We're doing it in a way that creates good jobs and future economic prosperity, very different from the members opposite. When he was in offi ce he raised the gas tax, cut the budget for highways, laid off people, including teachers, social workers, child -welfare workers and civil servants, had a higher rate of unemployment and lower economic growth. Mr. Pallister: Well, they're fine talking po ints from someone who doesn't respect the intelligence of Manitobans.

Now, Manitobans know that the interest rates for borrowing right now are about a fifth of what they were in the time period the Premier refers to and that the debt service charges are the same now as they were when the interest rates were five times as high, and the debt has multiplied enormously. So the provincial debt has to be serviced. The interest has to be paid on it and it has to be paid by those of us who live in this province in the future, including our children and our grandchildren. And the cost of servicing that debt must be borne by someone.

But when the debt is out of control, as Moody's has said, as Standard & Poor's has said, as various authorities have said, but –and that warning is ignored by this government, it's dangerous. It's reckless. And what is happening here is that the real cost of not listening is tens of millions of dollars every year that goes to happy moneylenders, Mr. Speaker, but does not go to health care, can't go to education and will be paid back someday by our kids.

So I'm going to ask the Premier again: Does he not understand–101 finance–does he not understand that when he doubles our debt he creates a dangerous situation for our children? Mr. Selinger: The arrogance coming out of the member opposite and his disrespect for Manitobans is legendary, Mr. Speaker. It's well known. Former governor of the Bank of Canada said the following about infrastructure, deficits and–at this time.

He said: At these very low interest rates, and given the need for infrastructure to allow for further economic development in Canada, it really does make sense at this point in time for governments to borrow in order to finance that infrastructure. David Dodge, I'll take his opinion on what Manitoba needs to do over the opinion of the Leader of the Opposition any day of the week. Mr. Pallister: Well, here's the opinion of the member for Minto (Mr. Swan): The Premier has lost sight of the priorities of Manitobans. His first priority is his re-election. And this year's deficit budget is a re -election budget.

It's a chance for t he Premier to use the excuse of borrowing more to ribbon cut, to do conspicuous construction, but to do ribbon cutting to buy votes. And that is exactly what his plan is. It is not a plan for the long- term success of our province. It's quite the contrary, Mr. Speaker. It's a plan for the weakening of our province. Now, the Premier himself has said that infrastructure is important, and we agree. However, it took him a full year to come up with that excuse after he raised the PST, didn't it, Mr. Speaker? A full year to come up with a PR program to sell his agenda.

And he underspent in the infrastructure budget for five consecutive years before that. So, Mr. Speaker, I have to ask the Premier, since he obviously has no financial plan except one: Will

October 22, 2015 LEGISLATIVE ASSEMBLY OF MANITOBA 2445 he admit that his plan for the future of Manitoba is deficits in perpetuity? Mr. Selinger: The member obviously hasn't read the opinions of the bond rating agencies. They say the following: The province's political and management culture is prudent and supporte d by a capable and experienced administration.

They go on to say: Manitoba is bucking the trend of other Prairie provinces and will be the second best performing economy in the country. * (13:50) This is the time, according to the former bank of governor, to invest in infrastructure, to ensure young people have good jobs, to make sure we're building for the future when interest rates are low. Our plan is to grow the province, to grow our prosperity, to make sure everybody has that opportunity. That's what we're doing. What is the vision and the plan of the Leader of the Opposition?

Cuts to services, unemployment rates that go up, less opportunities for young people, borrowing in the future when the cost goes up, Mr. Speaker. His plan takes us backwards; our plan takes us forward. Credit Rating Announcement Finance Minister's Response Mr. Cameron Friesen (Morden-Winkler): Mr. Speaker, the opinion of bond rating agencies is: a loss of fiscal discipline leading to debt and deficit. That's the opinion of the bond rating agencies. Mr.

Speaker, in July, when Moody's Investors Service downgraded the credit rating for Manitoba, the Winnipeg Free Press editorial read: Finance Minister nowhere to be found as credit rating falls. The

article states that the Finance Minister took a pass and made his communicators do his talking for him. And the

article goes on to say the Finance Minister was missing in action when Moody's registered the non- confidence vote on his fiscal strategy. Mr. Speaker, when a bond rati ng agency downgrades the province's credit rating and the Finance Minister goes missing, it is a serious issue of confidence and competence. Manitobans deserve to know, Mr. Finance Minister: Where were you? Hon. Greg Dewar (Minister of Finance): Mr.

Speaker, I was on the job, building our economy, working with labour, working with business, working with our educational partners, working with non-profit groups, working to reach our goal of having the lowest unemployment rating in Canada. We are No. 2. Our goal is to be No. 1. The–again, as I said, the only ones who aren't happy about the success of this province is the Leader of the Opposition and the gloom -and-doom members across the way. Mr. Friesen: Mr. Speaker, the Finance Minister says he w as on the job, but the Winnipeg Sun also reported the minister's absence, saying he was unavailable for comment.

Mr. Speaker, when an international bond rating agency downgrades the province's credit rating, it is a call to action for a Finance Minister. It is priority No. 1. It requires strong assurances to jittery lenders. Yet this NDP Finance Minister was unavailable, as the headline reads. I ask again: What was the Finance Minister doing that was more important than responding to the province's first credit downgrade in 30 years? Mr. Dewar : As I said, Mr. Speaker, Manitobans reject the gloom-and-doom tactics and philosophy of the members opposite.

You know, we have a new partner in Ottawa who's eager to work with us to grow the economy. I'll remind the member that the Bank of Canada– the governor of the Bank of Canada just yesterday downgraded Canada's economic performance. But we, Mr. Speaker, in Manitoba, I've tabled– or I haven't –many reports from banks and other agencies which are predicting that Manitoba will lead the nation in economic growth. That is good news for the province. That is the path we're on, and that is the path we'll continue on. Mr. Friesen: Well, Mr. Speaker, the dean of the Asper School of Business was on the job.

He was available for comment, and what he said is that the government was losing credibility to meet financial targets. He said that a downgrade would likely add millions of dollars in financing costs, even if interest rates climbed by a fraction of a percentage point. Basically, he said Manitobans are now paying more and getting less. He was also disappointed that the Finance Minister didn't respond with a strong plan of action.

2446 LEGISLATIVE ASSEMBLY OF MANITOBA October 22, 2015 Does the Minister of Finance understand that his absence and his inaction make the prospect more likely of additional rating downgrades? What convinced the Finance Minister that his time was better spent somewhere else rather than dealing with a fiscal crisis of his own party's making? Mr. Dewar: I wasn't in Costa Rica like the Leader of the Opposition, Mr. Speaker, when Manitoba was flooding. I want to remind the member, Mr.

Speaker, just a couple of stats: full-time employment in Manitoba, No. 1; total employment in Canada is in Manitoba, we're No. 1; private employment, we're No. 1 in Manitoba. As I said earlier, we have the second lowest unemployment rate in Canada. The bond rating agencies, they look at the bottom line. That's their job. As I said in my previous answer, I was in Toronto; I was in New York. I met with investors, Mr. Speaker. They have full confidence in this province. They know that Manitoba is a good place to invest. Mr.

Speaker, again, the only ones who are down on Manitoba is the Leader of the Opposition and his colleagues opposite. Small-Business Income Tax Limit NDP Election Promise Mrs. Heather Stefanson (Tuxedo): As we continue to celebrate Small Business Week in Manitoba, it's unfortunate to have to point out yet another broken promise by this NDP government. Mr. Speaker, during the 2011 election, not only did this Premier (Mr. Selinger) break his promise to Manitobans when he said he wouldn't raise taxes, but he made a promise to increase the small -business income limit to $500,000. Yet he has failed to make this happen.

Mr. Speaker, why has he broken his promise yet again to small businesses in Manitoba? Hon. Kevin Chief (Minister of Jobs and the Economy): It is Small Business Week, and I've been able to travel the province and get the opportunity to talk to many small businesses, Mr. Speaker, and without question, what this government recognizes, and we know, that small businesses create more than 75 per cent of all new jobs in our province.

We also know that small businesses recognize that young people are proud of who they are and they want to be able to give back, and the best way young people give back is by getting that critical first job, Mr. Speaker. It's small businesses that give them that first job, and we also know that small businesses all throughout the province help build the identity of neighbourhoods all throughout the province. We know, Mr. Speaker, that we have over 80,000 small businesses, and we'll continue to stand with them. Mrs.

Stefanson: The Premier's refusal to live up to his word in the last election has resulted in Manitoba falling to second last place in Canada with respect to the business income limit, Mr. Speaker. That's almost dead last in Canada. Mr. Speaker, why has this Premier broken his promise to small -business ow ners in Manitoba, forcing us into second last place in our country? Mr. Chief: Mr. Speaker, our government continues to stand with small businesses.

We're the only province in the entire country that has completely eliminated small-business tax, been able to increase the income threshold and so that includes more businesses. We're out –I was down in Morden, Manitoba, and we stood with the good folks, hundreds of small businesses, working with Entrepreneurship Manitoba, Mr. Speaker. And how are we doing that? We're helping them start businesses, registration, permits and licences, regulation, taxation, financial programs. Over and over again, we're showing how we're standing with our small businesses.

That's why people like Mike Moore from the Manitoba Home Builders' Association can confidently say there's no better place to start a small business than right here in Manitoba. Mrs. Stefanson: Mr. Speaker, I'm glad that the minister is visiting small businesses in Manitoba. I hope he starts listening to those small -business owners, because being almost dead last in our country is nothing to celebrate. Mr. Speaker, the Premier made a commitment in the 2011 election not to raise taxes, and he broke that promise.

He made a commitment to raise the small-business income tax limit to $500,000, yet he broke that promise too. With the litany of broken promises from this NDP government, how do they expect anyone to trust them again?

October 22, 2015 LEGISLATIVE ASSEMBLY OF MANITOBA 2447 Mr. Chief: Mr. Speaker, I proudly say that I was travelling around all over Manitoba, including Morden, Manitoba, where they proudly say a government standing with those small businesses. In fact, I was down in St. Boniface today at Pasquale's restaurant with Joe, and we were talking about–we were able to announce how we're working together to save Joe and Pasquale's restaurant some money, and that's going to happen all throughout Manitoba by this–the new Power Smart program.

Any time the member of Tuxedo wants to take the time and join me, I'll offer her to come down to Connie's C orner Cafe. She can hear first -hand how small businesses and how this government's standing with them. Not only would she get great information of how this government continues to stand with small businesses, Mr. Speaker, at the same time, she can have the best fried baloney in Winnipeg. Mining Industry Tax Rates Mr. Cliff Cullen (Spruce Woods): Baloney today, Mr. Speaker. Mr. Speaker, mining is the largest industrial sector in northern Manitoba.

Mining represents approximately 3 and a half per cent of our gross domestic product. The industry currently employs over 4,000 people, mainly in northern Manitoba. * (14:00) The industry is facing challenges not only from low commodity prices but also from a provincial government that has chosen to tax the industry at the highest rate in Canada, another example of Manitobans paying more and getting less. Mr. Speaker, why has the NDP chosen this approach at the peril of future development? Hon. Dave Chomiak (Minister of Mineral Resources): Mr.

Speaker, as my colleague has indicated, if you talk to people in the industry, if you talk to people that actually work in mining, if you talk to people that invest in mining, it's diametrically different than what we just heard from members opposite, the doom and gloom. In fact, let's –Callinex Mines' president said: Of course, Manitoba, it's safe, it's stable. Manitoba has an excellent infrastructure, an experienced workforce. The provincial government is very supportive of mining through its Mineral Exploration Assistance Program and issues rebates of up to 40 per cent. You know what? He said, Mr.

Speaker, we're one of the best places in the world to do mining, and that's been reflected by the fact that our expenditures for exploration this year are up from last year and down in seven other jurisdictions, even though tough–times are tough in the investment industry and in the mining industry. Investment in Exploration Mr. Cullen : Well, Mr. Speaker, exploration is the lifeblood of the mining sector. Clearly, we need a vibrant exploration sector to find the resources so that we can open mines in the future. Prospectors and developers compete with other jurisdictions to attract investment dollars. Mr.

Speaker, the question is, how is Manitoba doing compared to other jurisdictions here in Canada? Recent Natural Resources Canada statistics show that only 1.6 per cent of the tot al exploration dollars are being invested here in Manitoba. This represents over 50 per cent decline in the last seven years. Why has the NDP allowed this to happen? Mr. Chomiak: I–what the member conveniently overlooks, Mr. Speaker, is can he name anot her province in the country where two mines have been opened in the last year? He can't, because there's only one location in Canada where two new mines have opened: here in Manitoba.

And, Mr. Speaker, if you want to make comparisons, much as I hate to use the Fraser Institute, I notice that this year members did not mention the Fraser Institute in their doom-and-gloom questions. And you know why? Because this year the Fraser Institute said we were the second best in the country in terms of mining and i nvestment attractiveness. Very convenient, Mr. Speaker. Members opposite say one thing; we do things. Mr. Cullen: Well, Mr. Speaker, is the minister also going to take credit for the nine operations that were closed under their watch? Mr.

Speaker, investment dollars go where they are wanted, and clearly the NDP government are not sending the right message. People in the industry know that Manitoba has the worst tax regime in Canada, a dysfunctional permitting system, a lack of

2448 LEGISLATIVE ASSEMBLY OF MANITOBA October 22, 2015 clarity around land use, no framework for con - sultation, and the list goes on. As a result, statistics show investment in exploration is going elsewhere. Why has the NDP government turned its back on the industry here in Manitoba? Mr. Chomiak: I really thank the member for that question. Mr.

Speaker, first off, for the first time in history, we have the minister's Mining Advisory Council, where we have 10 chiefs, all of the heads of all of the mining and exploration companies and the Manitoba Mining Association sitting at a table with government to work on both practices and the future. And you know what the most important statistic is? At Vale, that members opposite wanted to give up on, 20 per cent of the workforce is First Nations, 20 per cent.

So of those thousands and thousands of jobs that we create in northern Manitoba, for the first time, 20 per cent are in mining at Vale, 30 per cent are in hydro. All jobs, all futures that members opposite want to cancel and do not believe in. Untendered Contracts Approval Process Mr. Kelvin Goertzen (Steinbach): Mr. Speaker, long before an untendered contract needs to be publicly disclosed, an issue which you've taken under advisement and I won't speak to, it needs to go through a proper approval process.

Manitoba laws require that untendered contracts of certain values get approval by certa in officials, ministers and Treasury Board. But over and over, for years and for years, different ministers and different Treasury Boards ignored those rules and didn't get the proper approval for millions of dollars of untendered contracts in Manitoba. I want to know why minister after minister and Treasury Board after Treasury Board was allowed to break the rules and not one minister on that side ever said anything about it. Hon.

Greg Dewar (Minister of Finance): Well, we know that Manitobans expect the government to be open and transparent, Mr. Speaker. That –also to remind the member that almost 80 per cent of all expenditures that the government makes go through a competitive process. And of the ones that don't –that's only 60 per cent–they are expenditures, for example, when only one provider is qualified, like, for example, Microsoft, or when we have to service our– Bombardier has to service our water bombers, excuse me. The other example, of course, is in emergency situations, Mr. Speaker.

You know, we can't simply say to the flood waters, can you simply wait, can you–we wait while we go and, like the member opposite wants us to do, and take 40 days to go to tender? The member opposite, that's a ridiculous question. Mr. Goertzen: Mr. Speaker , it was the Auditor General that indicated that this government, ministers and Treasury Board didn't follow the rules. When I asked the Minister of Finance at Public Accounts earlier this month how it is that a minister after minister, Treasury Board after Treasury Board, could break the rules, Mr.

Speaker, he said to me, "one would assume and we would expect that our staff is doing the job that they are assigned to do." Mr. Speaker, instead of throwing the public civil service, our dedicated, hard -working and profes- sional civil servants, under the bus, why won't this Minister of Finance acknowledge he's responsible? He and his government and his Premier (Mr. Selinger) should take responsibility and not blame it on the civil service. Mr. Dewar : As I said, almost 80 per cent of all contracts go through a tendering process.

And, again, a vast majority of those that don't are for situations, as I said, where there's only one provider, Microsoft, proprietary service to the government. We've now changed t he process. Before, only tendered–untendered contracts over 1,000 were reported. Now, Mr. Speaker, all contracts over $10,000 are now reported. Before on the –they were only on the Legislature –excuse me, in the library reading room of this building. Now all that information is available publicly online. Mr. Goertzen: Well, this is a government that's good at changing the rules after they get caught, Mr.

Speaker, after they break the rules. And here we see it again. Example after an example, minister after minister, Treasury Board after Treasury Board, year after year, this govern - ment broke the rules on untendered contracts and the approval of them. The Auditor General caught them.

October 22, 2015 LEGISLATIVE ASSEMBLY OF MANITOBA 2449 Now they say that they're going to change the rules, but millions of dolla rs of untendered contracts were already issued, and that cost Manitobans; that cost Manitoba families. And the best answer that the Minister of Finance could give us earlier this month was it was the fault of the civil service. Those professional civil s ervants aren't to blame. Why doesn't he take responsibility? Why doesn't the Premier (Mr. Selinger) take responsibility?

Why doesn't every member and former member of that Cabinet take responsibility in trying to say they're not at fault? They are at fault. Mr. Dewar : Mr. Speaker , the vast majority of contracts go through a tendering process. Again, those that don't, a vast majority of those are because of proprietary contracts and to provide services that they provide to the government, like Microsoft, like Bombardier. Again, a s I'll mention, when you're fighting a forest fire, Mr. Speaker, you don't just say, can you stop while we go 40 days through a tendering process?

We have–now we have one of the most transparent processes in Canada. Before, as I said, you'd have to go online to the Legislative reading room here to get that information. Now all contracts over $10,000 are disclosed in a public way. Dedicated Stroke Unit Government Position Mrs. Myrna Driedger (Charleswood): Mr. Speaker, for the third time this NDP government refused to pass a resolution this morning that would create a dedicated stroke unit. This unit would help to decrease disability and death from stroke by 30 per cent. It would save lives.

I'd like to ask the Minister of Health to explain her governme nt's stubborn refusal to improve the lives of stroke patients and their families with a dedicated stroke unit. Hon. Sharon Blady (Minister of Health): I'd like to thank the member for the question. And it was an opportunity today to again meet with the folks from the health–the Heart and Stroke Foundation, because we do have an ongoing relation- ship with them.

And I can assure Manitobans that we are doing the work that ensures that Manitobans do get great care. * (14:10) In fact, one of the most important times is that door-to-needle time when someone has a stroke, that access to clot -busting pharmaceuticals such as tPA. HSC has the best time; we have a 15 -minute needle- to-door time. The national standard is 60. The average time is 74 minutes. We're coming in at some of the best times. We're also providing supports to our EMS workers. We are–it's their–the work that they do, it's the most crucial time, that golden hour, the 52 new ambulances.

Other things we're doing, we're– Mr. Speaker: Order, ple ase. The honourable minister's time on this question has elapsed. Mrs. Driedger: The minister did not answer the question, and the Heart and Stroke Foundation were here this morning to support the resolution that this government would not pass. Mr. Speaker, Manitoba is the only province in all of Canada without a dedicated stroke unit. We are dead last. Manitobans are paying more and they're getting less. There are about 1,700 strokes per year in Manitoba, and 613 of those patients die.

The numbers are getting worse, and it's going to be a growing tsunami with our aging population. So I have to ask the Minister of Health: Do Manitobans not deserve the same level of stroke care as everybody else in Canada? Why are they punished by the geography of this province and this NDP government? Ms. Blady: Again, thank the member for the question. And I, again, thank the members of the Heart and Stroke Foundation for the work that they do. They have been our partners in so many projects. It's with them that we put AEDs throughout the province, in many cases providing them for free.

We have w orked with the Heart and Stroke Foundation on numerous projects, including that one, and it's about building a relationship. I've met with them earlier this month, and we have talked about next steps. So when the member opposite says that we won't work with the Heart and Stroke Foundation or that we're not, I can tell you that we have, we are and we will continue to work with the Heart and Stroke Foundation.

2450 LEGISLATIVE ASSEMBLY OF MANITOBA October 22, 2015 And, in fact, I can tell the member opposite that after we left the Chamber and this morning's debate I met with the members of the Heart and Stroke Foundation and we talked next steps. Mrs. Driedger: I met with them too, and they weren't very impressed with the [inaudible] Mr. Speaker, not only can lives be saved and disabilities prevented, but mone y can also be saved with a dedicated stroke unit. According to a recent economic analysis, Manitoba could save almost $20 million a year. So not only could we save lives, we could save some money.

So this Minister of Health has a second chance right now to do the right thing for Manitoba patients. Will she commit today to the establishment of a dedicated stroke unit for Manitoba for the right reasons? Ms. Blady: Thank the member for the question. And what I will commit to is to continue to work with the Heart and Stroke Foundation to build on the conversations that we had earlier this month, and what we will talk about is all the different things that have been done and how we can improve the system.

We have talked to them about best practices, about what is needed, about the direction that we want to go, the direction that they want to go. So I will continue to build relationships with the Heart and Stroke Foundation. The one thing I can also assure them, and conversations that we had, they are well aware that the one way you don't get a dedicated stroke unit is by cutting over half a billion dollars out of the budget. Ride-Sharing Services Regulation of Industry Hon. Jon Gerrard (River Heights): Mr.

Speaker, as Mayor Boris Johnson of London, England, and other civic leaders have found, it is less a question of banning ride-sharing businesses like Uber but more a question of how such businesses are regulated. We should be looking at regulations and how they're drafted for our province so that we provide equitable opportunities for Manitoba -based ride-sharing businesses and for our existing taxi businesses. What are the Premier's plans for regulation of ride-sharing businesses in our province? Hon. Greg Selinger (Premier): I thank the me mber for the question.

We will be issuing a request for proposals to work on improving services in the taxicab industry. The objectives of the review will be to ensure reliability, affordability, convenience and safety. These are vital factors. I notice the member opposite and his leader have never mentioned the word safety once. It's important that people get in a taxi that's properly licensed with a driver that's properly licensed and ensure that when people are going somewhere that they're safe when they do that and have proper insurance in place. These are the regulations we have in Manitoba.

The review will canvass all of those issues and ensure that the public is safe and has access to affordable, convenient, reliable and safe taxi service. Mr. Gerrard: Mr. Speaker, others have recognized the need and the advantage to being proactive and not just reacting. Instead of chaos and confusion over ride-sharing businesses, which can lead to unsafe conditions, there needs to be regulations which respect and provide opportunities for our traditional taxi businesses and regulations which provide opportunities for ride-sharing businesses.

Manitoba Liberals will introduce such fair regulations following discussions with all stake - holders and leading to equit able transportation options for Manitobans and fair and equitable treatment for those in the industry. Will the Premier be allowing ride -sharing services to exist in Manitoba, or will he attempt to ban them? Mr. Selinger: Mr. Speaker, the Leader of the Liberal Party has already announced that she's going to fully welcome Uber into Manitoba.

She has not addressed the issue of safety, nor has the issue of insurance been addressed, nor has the issue of proper licensing for both the vehicles and the drivers been addressed, Mr. Speaker. Those are important issues. We want a safe, convenient, affordable system that's reliable. That's why we have regulation of the industry. The review will canvass all of those issues, make sure everybody's heard and consulted, Mr. Speaker. We'll come back with an approach that allows the industry to meet all of those objectives. And I will say this to the member opposite. I know that when his colleague Mr.

Lamoureux was in the Legislature, he was one of the biggest advocates

October 22, 2015 LEGISLATIVE ASSEMBLY OF MANITOBA 2451 for protecting the existing taxicab industry, Mr. Speaker. I wonder if the Leader of the Liberal Party has consulted with the members of the federal Liberal Party on where they stand on Uber being fully welcomed in Manitoba. Some Honourable Members: Oh, oh. Mr. Speaker: The honourable –order. The honour - able member for River Heights. Mr. Gerrard: –and there are many in Manitoba who are interested in learning more about the possibility of ride -sharing services operating in our province.

Manitoba businesses want to know how they can provide such ride-sharing services. Manitoba citizens want options allowing them to make their own choices and to be able to use the taxi service we have today or to use their smartphones and apps to access more 'chansportation' opti ons like ride -sharing services. When will the Premier introduce legislation and regulations to ensure that our traditional 'traxi' drivers will be listened to and provided fair treatment while at the same time providing options for ride sharing? When will the legislation be introduced? Mr. Selinger: Mr.

Speaker, that's not what the Leader of the Liberal Party said this morning. The 'lither' of the Liberal Party said that they're going to introduce and fully welcome Uber into Winnipeg. The issue of safe ty was not even mentioned in the release or the conversation. That is vitally important. Priority No. 1 is to make sure everybody that uses a service called a taxi for which they pay is in a safe vehicle with a licensed driver and a properly insured vehicle. The review that we're launching will canvass all of those issues: reliability, affordability, safety and convenience.

All of those issues will be canvassed, and then we will come back with recommendations of that, and everybody can have input into that , including the member opposite, including the Leader of the Liberal Party. But what we won't do, Mr. Speaker, is say we're going to do it first and then figure out what the issues are second. Cervical Cancer Improved Screening Mr. Dave Gaudreau (St. Norbert): Mr. Speaker, in 2010, after a 12- year battle with cancer, I lost my mother. And I have to say that the hospital staff was top-notch, and her doctor's actually a world–was a world-renowned doctor on cancer care.

I'm very proud of our government' s record on investing in new, innovative health-care services and improving the health care for Manitoba. That's why I was excited to hear about the minister's health announcement today that invests in efficiencies and pays off in cancer 'provettion' –prevention and early diagnosis and treatment. * (14:20) The Leader of the Opposition doesn't have a plan for improving health care. In fact, his plan is to slash a half a billion dollars from the budget and jeopardize those very lives and very services that Manitobans need the most.

Can the Minister of Health please inform the House of what our NDP government is doing to improve cancer care for women and young Manitobans? Hon. Sharon Blady (Minister of Health): I'd like to thank the member for the question. I don't know if Manitobans are aware that this week is Cervical Cancer Awareness Week, and today I was able to go and see the cytology lab. We have new liquid -based cytology that was launched this past year.

And as a cervical cancer survivor, I can tel l you what this research really means in terms of the pain and suffering that it's going to save women as they sit and wait anxiously for results, because we get better results. I was part of that 6 per cent that had to get retested. We've got that down to 1 per cent now with this lab.

There are hundreds, there are thousands of women who are going to be saved the grief of being retested only to find out they don't have cancer or are going to be saved the process of being retested because now we can get them accurate results faster and get them into the In Sixty program and get them care. And we're also working in investing in pre - vention, because yesterday I was able to announce that we are expanding the HPV vaccination for boys at grade 6. So we're inves ting in care. We're investing in preventing cancer, and we know that that– Mr. Speaker: Order, please.

The honourable minister's time has elapsed.

2452 LEGISLATIVE ASSEMBLY OF MANITOBA October 22, 2015 Farmland School Tax Women's Eligibility Mr. Blaine Pedersen (Midland): Mr. Speaker, the Minister of Agric ulture broke his promise to farm families by changing the rules and placing a cap on the farmland education tax rebate, and as a result of this rule changes, in addition to placing a cap on the actual rebate that farm families can get, these rules have disallowed many farm women landowners to be eligible from the program, and as a result they are not eligible for this rebate program.

So the question is: Why would the Minister of Agriculture selectively exclude farm women from a rebate program? Hon. Ron Kostyshyn (Minister of Agriculture, Food and Rural Development): It's truly my privilege to stand up and maybe relay the question and answer it later, but let me say this. Let's take the time to recognize the importance of agriculture in the province of Manitoba and show a round of applause for the hard -working farmers, the farm families in the province of Manitoba. Mr. Speaker, regarding the school land tax rebate, women who own farmland can certainly apply for the rebate.

Spouses and corporations, farm families must also share in the rebate cap. Of 35,000 applications in the province of Manitoba, 1,000 are only impacted by the cap of $5,000. That is a due diligence. But let's not forget the scoreboard. When– Mr. Speaker: Order, please. The honourable minister's time on this question has elapsed. Rebate Cap Mr. Pedersen: So with that answer that he was not willing to give at the start, he's now said that 1,000 farm families are being taxed unnecessarily by this government. And it's in their greed and absolute –Manitobans are tired of the same NDP broken promises.

They promised to extend this program. Instead, they introduced a cap. They've excluded farm women landowners. There is no appeal process, because there are farm families out there who have faced illness, who have faced death, and they have missed that deadline, and this Minister of Agriculture has said no appeals, no chance of getting their rebate. Why is this Minister of Agriculture so determined to take tax money from rural Manitoba farmland owners? Mr. Kostyshyn : I guess the 1,000 applicants were meeting the criteria or not meeting the criteria, but you know what?

When they were in power, there was 30,000 applications that were not even considered by the members opposite, so I question them, where was their sincerity to help out farm families when they existed?

I stand here on this side of the House very proud of the NDP government that we work for the betterment of farm families in supporting local family effor ts and opportunities of developing the rural economic development in the future –not only today but into the future –because we are committed to work with farm families, not what the Conservatives are choosing to do: cut out $550 million and the school t axes and the opportunity of keeping schools –country schools in existence when they choose to cut out education in the future. Mr. Speaker: Time for oral questions has elapsed. PETITIONS Mr.

Speaker: It is now time for petitions. Provincial Trunk Highway 206 and Cedar Avenue in Oakbank–Pedestrian Safety Mr. Ron Schuler (St. Paul): Mr. Speaker, I wish to present the following petition to the Legislative Assembly. The background to this petition is as follows:

(1) Every day, hundreds of Manitoba childr en walk to school in Oakbank and must cross PTH 206 at the intersection with Cedar Avenue.

(2) There have been many dangerous incidents where drivers use the right shoulder to pass vehicles that have stopped at the traffic light waiting to turn left at this intersection.

(3) Law enforcement officials have identified this intersection as a hot spot of concern for safety of schoolchildren, drivers and emergency responders. We petition the Legislative Assembly of Manitoba as follows: To urge that the prov incial government improve the safety at the pedestrian corridor at the intersection of PTH 206 and Cedar Avenue in Oakbank by considering such steps as highlighting

October 22, 2015 LEGISLATIVE ASSEMBLY OF MANITOBA 2453 pavement markings to better indicate the location of the shoulders and crosswalk, as well a s installing a lighted crosswalk structure. This is signed by R. Jones, M. Kuik, D. Joycey and many, many other fine Manitobans. Thank you. Mr. Speaker: In keeping with our rule 132(6), when petitions are read they are deemed to have been received by the House. Proposed Lac du Bonnet Marina– Request for Research into Benefits and Costs Mr. Wayne Ewasko (Lac du Bonnet): I wish to present the following pe tition to the Legislative Assembly. And these are the reasons for this petition:

(1) Lac du Bonnet is a recreational area with great natural beauty.

(2) The Winnipeg River is one of the greatest distinguishing cultural and recreational resources in that area.

(3) Manitoba marinas increase recreational access and increase the desirability of properties in their host communities.

(4) The people of Lac du Bonnet overwhelm - ingly support a public harbourfront marina in Lac du Bonnet. We petition the Leg islative Assembly of Manitoba as follows: To urge the provincial government to consider collaborating with other levels of government to research the economic benefits and construction costs of a marina in Lac du Bonnet. This petition is signed by M. Hiy sio, G. Short, B. Lesko and many, many more fine Manitobans. Minnesota-Manitoba Transmission Line Route– Information Request Mr. Dennis Smook (La Verendrye) : I wish to present the following petition to the Legislative Assembly of Manitoba. The background to this petition is as follows:

(1) The Minnesota-Manitoba transmission line is a 500- kilovolt alternating -current transmission line set to be located in southeastern Manitoba that will cross into the US south of Piney, Manitoba –south– border south to Piney, Manitoba.

(2) The line has an in -service date of 2020 and will run approximately 150 kilometres with tower heights expected to reach between 40 and 60 metres and be located every four to five hundred metres.

(3) The preferred route designated for the line will see hydro towers come in close proximity to the community of La Broquerie and many other communities in Manitoba's southeast rather than an alternate route that was also considered.

(4) The alternate route would have seen the line run further east, avoid densely populated areas and eventually terminate at the same spot at the US border.

(5) The Progressive Conservative caucus has repeatedly asked for information about the routing of the line and its proximity to densely popula ted areas and has yet to receive any response.

(6) Landowners across Manitoba are concerned about the impact hydro line routing could have on land values. We petition the Legislative Assembly of Manitoba as follows: To urge the Minister responsible for Manitoba Hydro to immediately provide a written explanation to all members of the Legislative Assembly regarding what criteria were used and the reasons for selecting the preferred routing for the Minnesota - Manitoba transmission line, including whether or not this routing represented the least intrusive option to residents of Taché, Springfield, Ste. Anne, Stuartburn, Piney and La Broquerie.

This petition is signed by S. Miller, D. Carruthers, S. Neves and many more fine Manitobans. Mr. Speaker: That concludes petitions. We will now move on to grievances. ORDERS OF THE DAY (Continued) GOVERNMENT BUSINESS Mr. Speaker: Seeing no grievances, we'll call orders of the day, government business. Hon. Dave Chomiak (Government House Leader): Mr. Speaker, again , I want to thank the House for allowing for this morning's leave for no quorum. I appreciate the co- operation of all the House in all these matters and it fits in with our

2454 LEGISLATIVE ASSEMBLY OF MANITOBA October 22, 2015 movement towards efficient and more effectively dealing with people's business. Having said that, Mr. Speaker, I'd like to resolve the House into Committee of Supply. Mr. Speaker: We'll now resolve into Committee of Supply. Madam Deputy Speaker, will you please take the Chair, and committee Chairs to the various committee rooms. COMMITTEE OF SUPPLY (Concurrent Sections) HEALTH, HEALTHY LIVING AND SENIORS * (14:40) The Acting Chairperson (Dave Gaudreau ): Will the Committee of Supply please come to order. This

section of the Committee of Supply will now resume consideration of the Estimates for the Department of Health, Healthy Living and Seniors. As previously agreed, questioning for this department will proceed in a global manner. Floor is now open for questions. Hon. Sharon Blady (Minister of Health): I was just hoping that –I have answers from the last time we met in Estimates and I was hoping that I could have leave to read those answers into the record before we proceed to questions. The Acting Chairperson (Dave Gaudreau): Is that agreed to have leave? [Agreed] Please proceed, Honourable Minister. Ms.

Blady: Again, I'd like to take the opportunity at the start, as I said, to read into the record some of the answers to some of the opposition's questions that were posed when we were last in the Committee of Supply this spring. And I will read the questions and then the brief–and then a brief response. The first question that I have an answer to from members opposite was a question of: Did the Souris Personal Care Home re- open their held beds on May 2014 or May 2015? And I can assure members that the regional health authority confirmed that those beds were open as of May 2014.

Second question that I have for members opposite related to the question was for unannounced reviews: How is the facility, in this case a personal care home, not aware of unannounced reviews?

I can assure members that in terms of the answer that the idea is that we brought in the PCH standards in 2005, put them into law, something that the Auditor General calls a significant achievement, and that with that, that means that each and every PCH is visited every two years to be inspected against standards that include infection control involving residents and family within care, restraint use and ensuring a safe and secure resident environment. We also introduced unannounced inspections in 2004 and have since increased the frequency of these visits.

Should a facility not meet a standard, they are required to develop an action plan within 60 days and implement it within another 60 days. At any point during this time, Manitoba Health may perform an unannounced visit to check up on that facility. And, by the very nature of unannounced reviews, they are unannounced to the PCH facility. It is a surprise review for the PCH; however, not for the region itself, though.

The facility name, date and time of the unannounced review is known to the regional representative who must join the departmental personal care home standards consultants in doing the actual unannounced review. And it is in working with the re gional health authorities that the unannounced nature of these reviews is stressed, with the expectation that the date, time and personal -care home for the unannounced review is kept in confidence at the regional program level and is not shared with the facility leadership.

We also had some questions that related –from opposition members –that related to the Prairie Mountain Health and, again, I will provide the answers to those particular questions. Questions that we got related to Prairie Mountain Health b egan with, what is the current situation with the leaking roof at the Minnedosa Personal Care Home and has the roof been completely repaired. To date, I can say that the roof has been patched as required. The site review with a consultant was completed on Tuesday, September 1st of this year, and the region expects that the roof repair will be completed by the end of this year.

A subsequent question from members opposite related to Prairie Mountain Health was, what occurred in relation to a resident at the Minnedosa Personal Care Home who was –and I, there's a quote here–without heat in their room through most of last winter. I can answer by saying that the comfort and safety of residents in all of our personal -care homes is a top priority, and I do thank the member for

October 22, 2015 LEGISLATIVE ASSEMBLY OF MANITOBA 2455 raising the question. I understand that a baseboard heater malfunctioned in one resident room at the Minnedosa Personal Care Home, but that it was repaired within 24 hours, and the supervisor has indicated that it is standard practice to ensur e that temporary heat is available in such an instance. A subsequent question, believe from the same member, was the –was an inquiry as to the current state of –oh, pardon me, no, it must have been a different member –the current state of vacant positions and closed beds at the Virden personal-care home.

In response to that question, I can say that I understand that the Westman personal -care home hired nine new health- care aides on June 8th, and they have been admitting throughout the summer. There currently are no beds which are closed or on hold, and as of earlier this month there were four vacant beds due to lack of applicable clients.

There was a subsequent question that asked a question regarding the Souris Personal Care Home, same question in terms of vacant position and closed beds, and as I'd indicated previously, the Souris Personal Care Home reopened their held beds in May 2014 and as of earlier this month they had some empty beds. But, again, no one on the waitlist for that particular personal care home. There was an additional question regarding how many beds are currently closed in Prairie Mountain Health due to staffing shortages. I'm pleased to say that there are no beds closed in Prairie Mountain Health due to staffing challenges.

The member opposite made reference to com - ments about a statement that the majority of postings are for part -time nurses mentioned in relation to Virden, Melita and Minnedosa, and a question that asked had there been nurses seeking full time that could not get it. The Westman personal care home in Virden recently posted for and hired a 1.0 registered nurse position.

The region reports that they have not been informed of nurses seeking full -time work that cannot get it and, in fact, often find the opposite: that many nurses don't want full -time work and, in fact, would prefer a lower equivalent full time and EFT that allows them the freedom to pick up additional shifts when they desire.

Where more nursing staff are required the region does work closely with the nurses to try to find them a position as close as possible to their desired number of hours, and it may be that some nurses are not finding the EFT they want in the exact community facility or unit that they would prefer.

There's a further question asking if I was aware of any nurse practitioner approaching Prairie Mountain Health for a job, but there were no openings, and according the member's question, this would have been some time prior to June 2015, the member was enquiring if there are vacant nurse-practitioner jobs at this time and how long have they been vacant. I can say that since last October, Prairie Mountain Health has had nurse-practitioner vacancies in Swan River, Ste. Rose and term positions in Erikson and Birtle. The Birtle position was fille d in May.

The position in Minnedosa was being filled as of early October with a nurse practitioner being offered the position at that time. As of June 1st, there was also a vacancy in Rossburn, which has been posted and remains vacant as of early October. * (14:50) The prairie mountain regional –Prairie Mountain Health region has also had a posting up for the mobile bus since July with a qualified applicant coming in from the United States. The region is working with Service Canada to bring this applicant to Manitoba. And if a potential employee accessed the website, they would have seen these postings.

The manager currently in the position has confirmed that she has never had an NP apply for a job where there were no positions available. Prairie Mountain Health reports also that the executive management team has always been very supportive of advancing primary care and advocating and supporting nurse practitioner recruitment in order to better address primary -care-services needs in their communities. There was also a question from member opposite regarding the current status on doctors in the town of Melita.

There is currently a part -time physician who provides acute, long- term care and ER services as well as primary -care services. Another physician provides primary-care services three days per week, and there is also a physician assistant providing primary-care services three days per week. Prairie Mountain Health is also currently supporting a nurse practitioner from the area in completing her course of training through a return- of-service agreement.

There were also questions regarding the funding to the regional health authorities for the 3.6 hours of care and how 3.6 hours of care is calculated in relationship to personal-care-home residents. And, as

2456 LEGISLATIVE ASSEMBLY OF MANITOBA October 22, 2015 mentioned earlier, the safety of personal -care-home residents remains a top priority for this government and will continue to be so. The hours -per-resident- day requirement that the member refers to is calculated based on paid hours for the staffing categories per number of personal -care-home residents. There was a subsequent question asking facilities doing–are facilities doing standards only for the review or are they doing them all the time?

The expectation of the department is that all facilities should be able to meet all of the standards every day so that if an unannounced review is conducted, the measures assessed will be met. There was an additional question regarding if the department is reporting standard review results. The standard review report s are provided to the region and to the individual facility.

In the past, high-level summarized results were also released through FIPPA requests, and as of last month, we chose to make this information more readily available for members of the public by posting standard review results going back to 2014. And there was one final question that asked how many panelled individuals in Prairie Mountain Health are waiting in hospital for a PCH bed. And as of July 31st, 2015, there were 42 people on a personal-care-home wait -list through the Prairie Mountain Health region. The Acting Chairperson (Dave Gaudreau): I thank the minister for that. The floor is now open for questions.

Mr. Dennis Smook (La Verendrye) : On June the 8th of this year at these Estimates, I asked the minister about the collaborative emergency pilot project for the Vita hospital. The response I got back from the minister was, I know that the feedback that I've gotten from folks in the community is definitely an eagerness to put this together, so, for me, it's a case of how it is that we make it happen and how it is that we make it happen in a way that will best suit the needs of the Vita community. The minister also promised to facilitate a meeting between the RHA, herself and stakeholders.

Well, it's now going on five months since I asked this question and the minister made the promise to have a meeting. I'm just wondering how that's going because is this standard procedure for the minister to take five months to set up even a sma ll meeting or even get back to me with what she may be doing. I've heard nothing from the minister. The ER at the Vita hospital has been closed for over three years with three Health ministers.

Every one of those ministers made a promise to either have it open shortly or to set up a pilot project for the collaborative emergency pilot project, but yet three years and nothing has happened. I mean, does the minister at all care about the people in southeastern Manitoba, or is that just what her standard is, to make people wait that long to have things happen? Madam Minister, if you're looking there's – summit was on June the 8th, and I believe the minister's answer might have been on June the 9th where she might have even said get 'er done, like she was ver y enthused about getting this going immediately.

And five months as far as I'm concerned and as far as the people of southeastern Manitoba are concerned, is way too much time for something as important as their health care. Ms. Blady: I appreciate the diligence with which the member has followed through on looking through Hansards and keeping track of these things, and I can assure him that him that we have, again, conveyed to the community and himself that, again, we would like to test the collaborative e mergency care model in Vita.

The discussions are still under way on how to best staff and formalize this model of care in Vita, appreciating that it would be the first such site in Manitoba. And we have been clear with the Southern Health region and the department that any proposal for a collaborative emergency care centre in Vita must not take financial resources from physician remuneration funding–meaning that, again, we are going to work on this model so long as it means that a physician recruitment in this area is, you know, doesn't mean that it's going to be impacted or that it could possibly cease.

We want to ensure that we are still working on physician recruitment. So there is work going on and there is, again, discussion happening, and it is one of those things that in terms of the work that is being done within the area we know that the region continues to work on physician recruitment, and we have not removed the funding for the emergency room coverage in Vita. The money for staffing is still o n the table. And, again, I can assure folks in that area that the Vita health centre is still offering clinical and

October 22, 2015 LEGISLATIVE ASSEMBLY OF MANITOBA 2457 hospital support, and that when staffing levels do shift, the region must ensure patient safety and adjust the services accordingly. And, again, what we will do is I will make sure that, again, in light of the comments made, that we will have a meeting set up. I will task my staff to do that right here and now to ensure that a meeting happens and that the member will be advised of the date of the meeting. Mr.

Smook : Do you have any copies of correspondence that you sent out, say, to whoever it is you say you sent it, to the local community, whether it be the RM or whatever? If you have sent correspondence, I would like, since that June 8th date, would you provide me with copies of it, please. And the meeting is the most important thing, because it's not only the ER because the ER has been closed for such a long time. You were very much in favour of getting this collaborative pilot project done and you made comments that made it lead to believe that you were working on it and would get it done immediately.

But you haven't even been able to set up a meeting, and could you set some guidelines and timelines as to when this meeting will happen? Ms. Blady: I thank the member for his, again, passion for his community on this. And, yes, I do have an interest in resolving this because I do think that what we are providing to that community with the –presently the 2.5 EFT physician positions serving the c ommunity and providing that primary care Monday to Friday and the medical supervision for the in-patients at the Vita district health centre is crucial, but that, again, we can always do more.

I know that there have been ongoing conversations, that there are always ongoing conversations between the department and the region as to correspondence that relates to this. I know much has come out of meetings. So I can say that what we will do is we will endeavour to get a meeting actually before the end of this m onth, if possible, but we, you know, again, within the immediate future. * (15:00) Mr.

Smook: I'd just like to make the comment that I've heard all these comments before, and I just want to make sure that something is done this time because we're talking about the –an emergency room and an ambulance service, because where it is in southeastern Manitoba, the distances to travel are great. And, when somebody has a heart attack that's 30 minutes outside of Vita and they got to get him to Steinbach, that's half an hour for the ambulance to get there and then an hour to get back to where it should be. That is too long. And the minister has made promises that she is not keeping.

And I want to put this on record that she knows about this because if something happens to somebody in that com - munity, I will personally hold her responsible for it. Ms.

Blady: Again, I appreciate the members concern for his community and that, again, when we have things like the, again, the clinical hours and depending on the level of care required, we know that non-emergent walk-in patients to facilities under nurse managed care are triaged, we know that we have the 2.5 doctors there, we've got a variety of things in pla ce, but I know that, again, you want more for this community and we will continue to work with the community I'm also proud of the work that we have been doing in terms of supporting those emergency facilities, our emergency providers, that 52 addi - tional ambulances and the quality of those ambulances will also help support folks.

But, again, what's most important is getting that care close to home. So I appreciate the question. Mr. Smook : How many more advance- care paramedics do you have in the southern RHA or any place in rural Manitoba and what is the answer to getting more of them? Ms. Blady: Just checking with my deputy. We don't have the exact numbers at hand, but when I –one thing I can say is that we do have a new program at Red River community col lege that is a class of 16 advanced-care paramedics and it is with the goal of doing exactly that, getting more advanced- care paramedics into the rural areas.

And so that is a program that I'm quite happy to see and I really want to thank my colleague th e Minister for Education and Advanced Learning (Mr. Allum) for helping work on that project because it's something that, again, in working with the paramedics in our province, we have some phenomenal folks there, and the ability to get more advanced-care paramedics, it is really about how we can best use those resources. I know they are eager to be out on the ground and doing that work and I am eager to have them there. Mr.

Smook : The last numbers I got from the minister was, there was one extended, advanced-care paramedic in southern RHA and four in Interlake eastern. With one paramedic it's pretty hard to start a program. So I'd like to know what the minister is–are there more on the way to southern RHA?

2458 LEGISLATIVE ASSEMBLY OF MANITOBA October 22, 2015 Ms. Blady: Because it has been several months since we have met last, I will endeavour to get the most accurate information on the most recent numbers from both regional health authorities. Mrs. Myrna Driedger (Charleswood): The minister still hasn't gotten back to me on one of the questions I had asked her in Estimates and she had actually committed to putting it in writing and sending it forth in writing, but I would ask her again which of the Winnipeg ERs have fast -track streams and how are those actually structured? Ms.

Blady: Yes, I'd like to thank the member for the question, and I do apologize for the fact that we haven't got that answer to you in writing. It was my understanding that it would have been there within this time, so I have tasked my staff to see if we can get it for today and, if not, for tomorrow. And, again, my apologies. Mrs. Driedger: Can the minister just verbally give some indication of what these fast tracks look like and whether all of the Winnipeg ERs actually have fast tracks?

I know it was recommended in the 2004 ER task force, and the minister has indicated that it had been implemented when she responded on June 2nd. So I would ask her if she could just give a brief verbal description of how these fast-track streams are actually functioning, and if the y are in every Winnipeg ER. Ms. Blady: As the member noted, that in 2004 the Emergency Care Task Force did make 44 recom - mendations and that as a government we did commit to putting in the necessary funding, resources, and expertise in place to meet them all.

And, as a result, you know, in having launched the emergency task care–Emergency Care Task Force to work with patients, front -line staff and hospitals, again, to develop a plan to improve emergency care in Winnipeg–and I can say that all the reco m- mendations have been acted upon and all but one are fully implemented. And one of the long- term recommendations regarding the health information system project is the one that is still going on.

That was having to do with phased in improvements to electronic hospital information that are allowing patient records to be shared within hospitals and long-term care facilities. * (15:10) In relation to the fast -tracking idea, one has to remember that the length of time that has happened and events that have happened subsequent to this–we will endeavour to find those things that still fit within that definition, but what has happened is there has been much evolution.

So, while the Emergency Care Task Force, in terms of the implemented recom - mendations include d re -developing the emergency rooms, the emergency rooms at Health Sciences Centre, Seven Oaks, Concordia, Misericordia urgent care, St. Boniface and Victoria have been re- developed, and the same is going to be happening at the Grace Hospital emergency room. But, again, these things have happened –the evolution of these things has happened over time, as well as subsequent events have occurred.

So we know that, and I will be checking with the WRHA to see what things still fit into the definition of the fast - tracking process, what other new things have come in. Again, for example, you know, the introduction of the reassessment nurses to the ERs to ensure that waiting patients are regularly reassessed and to communicate with patients and families was some - thing that was very significant and that the WRHA was, in fact, the first jurisdiction to implement this role in Canada. And so all ERs do now, in fact, have reassessment nurses in place today.

We have follow-up with patients who leave without being seen, via Health Links. And, again, we've also increased the geriatric program assessment team that conduct home assessments of discharged patients to help decrease the need for ER visits. So it's about establishing these kinds of pro- tocols. There's a variety of things that have been done that, again, since those original '04 recom - mendations and what would be defined as a fast track in the ER.

I can get her a more specific thing as to– more specific information as to what things fit within that definition and w hat things have evolved differently, grown further and may no longer be defined as fast -tracked but may actually have supplemental supports and information. Mrs. Driedger: Will the minister endeavour to approach the WRHA and have them also provide input into that document? Ms. Blady: Yes, I will. In fact, that was the–going to be the source that I was going to go to to ensure that their

definitions, what is being used, how each emergency room is set up, would be part of that. So, no, I will gladly work with the WRHA to get you that information.

October 22, 2015 LEGISLATIVE ASSEMBLY OF MANITOBA 2459 Mrs. Driedger: Can the minister tell us how many acute-care beds are in the system? I note that it used to always be in the annual reports, and then at some point, under the NDP, it disappeared from the annual reports. So can the minister indica te how many acute-care beds there are in Manitoba? Ms. Blady: Having one of those wonderful 21st-century moments wherein, having moved every- thing to electronic format, that we have got an answer, but it is meant much time with iPads rather than flipping through hard copies.

And I think this is where my 20th -century roots show, in that I think I would feel much more comfortable flipping through a hard copy of an annual report myself. But I can assure the member opposite that there are 3,949 acute -care beds.

And that, again, having moved to electronic records –and also having changed the format of the annual report to focus on population health numbers, population health care, rather than a count of merely beds, knowing that health-care provision is not always provided within a bed, again, there's been a difference in format, including, as I said, its moving to an electronic form, which apparentl y makes things easier here in the Committee of Supply. Mrs. Driedger: I would just make a comment to what the minister just said in terms of not carrying some of that information.

It does take accountability away, though, because it disallows the public f rom knowing some of the key numbers in health care, you know, based on what the government chooses to actually provide. So, while I agree and support, you know, putting in the annual report more related to population health and then–and other aspects, it certainly doesn't cover off some of the questions that the public might have. * (15:20) One of the other questions I would have is the full-time, part-time ratio when it comes to nurses.

I know that the NDP had made a commitment to increase more full -time nursing positions, and the last I had seen of that, they were struggling to keep that promise. Can the minister indicate now where they are in reaching that promise, or have they totally given up on trying to reach that more –a higher percentage of full-time nurses in the system? Ms. Blady: Again, we do have a growing number of nurses working within the system.

And, in fact, it was actually quite nice yesterday morning to be able to join this year's class of nurses coming through the nursing college at their pinning ceremony and knowing that there were, I believe, 129 new nurses that joined the profession yesterday. So we did commit to hire 2,000 more nurses by 2015, including 1,000 to replace the anticipated retirements and the 1,000 new nurses to put more nurses on the front lines to care for patients and to increase the time that they can spend at the bedside.

And what happened was we had–there was 1,731 retiring nurses that have been replaced, and 688 net new nurses have been added to registries for a total of 2,419 nurses added since 2011, again, not including yesterday's graduating class, obviously. The gains –and a few more that have come in from elsewhere. The gains are attributed to expanding, again, more nursing opportunities and ongoing recrui tment and retention initiatives to attract more nurses. The targeted recruitment funding has provided $9 million to relocation cost assistance to 2,030 new nurses who have moved to Manitoba from out of province.

And over 1,000 of these nurses have gone int o the rural and northern Manitoba. We do have part-time nurses. I believe the count as of December 14th we did have 6,571 part -time nurses and 4,993 full -time. Of course, again, those numbers, we know things have changed in that time. I am happy to say that, you know, at the end of 2014 we had more practising nurses in Manitoba than ever before with 17,806, which, again, is, you know, over 3,000–almost 3,000-plus, yes, higher than it was in 1999. I'm sorry; I'm trying to do the math here in my head. It was higher than the 14,092 when we came into office.

So we are continuing to work. I'm also very proud of the contract that we have worked out with the Manitoba Nurses Union because of what that does and how it does work on building a better system for nurses. And, again, it's one of those things where, you know, we had nurses voting over 90 per cent in favour of that new contract that –and a contract that demonstrates respect for them and the work that they do. And so, again, it wasn't just about paying the m more; it was about committing to, again, some of their concerns and about building a working relation- ship to fulfill those commitments.

So, again, it was one of those things that I'm very proud of the working relationship we have. I'm very thankful for the work that our colleges do as well. And, again, in

2460 LEGISLATIVE ASSEMBLY OF MANITOBA October 22, 2015 terms of that contract, I think the part that I was the happiest in terms of their response was the fact that they said that, you know, again, back under a previous government in the '90s, that only one in five nurses in Manitoba would recommend their profession, and today four in five would recommend being a nurse in Manitoba. And I think that large graduating class that we saw yesterday of 129 students was testament to that. Mrs. Driedger: Can the mi nister indicate what the ratio is or what the percentage is of part -time nurses to full -time nurses?

I believe the promise that had been made by the NDP a number of years ago was something like moving towards 60 per cent full -time or in that vicinity. Do you have that or does the province now have that percentage of nurses working full-time? * (15:30) Ms. Blady: Again, in looking at the increased numbers, and, again, discussions regarding the MNU contract, that is part of an ongoing project to get, again, more and more nurses working and working in environments that, and in positions that they want to have.

In other words, making sure that there are full-time positions available for those that want them and part-time ones for those, again, that chose that. It's part of a larger commitment to nursing optimization and it is the maximizing –the use of our professional nursing resources is really a key component in promoting and maintaining efficiency and effectiveness of the health services provincially.

And so in order to establish a process for health system improvements, it's been about a collaboration between employers and the department who are working, again, with the Manitoba Nurses Union and its members as part of a settlement that was ratified, again, back in April '14 through a memorandum of understanding entitled Collaborative Discussions to Optimize Patient Care.

And it's over the term of the current collective agreements that this committee is focusing on efforts towards working collaboratively within the health system to achieve a variety of goals which does include the creation of a balance of full and part-time positions, improve quality of work -life balance through the implementation of the groups self-scheduling guidelines and the improved us e of weekend staffing resources through broader implementation of the weekend worker.

So, again, in order to achieve these and other systems efficiencies and measures of success, there is going to be some –there is data that has been reported and analyzed and, again, it's about raw EFT data that exists within our HR and scheduling and payroll software residing within each of the RHAs. And I've come to learn a little bit more of that recently that part of the data around that is also about distinguishing between the different types of nurses, and so whether things, for example, like payroll software and data is identifying whether someone is an LPN, an RN or an RPN.

And so, again, work is being done to make the reporting

definitions of full and part -time on es consistent among the regions as well as trying to find consistencies within these recordings. So we are going to continue to work with the RHAs to, again, make sure that the

definitions are consistent so then an accurate count can be given because it's from having that accurate count that, again, we can move forward. So it's about those provincial baseline measurements and metrics. And, again, the idea of establishing what these are and the impact on shifting nursing EFTs towards, again, the more optimal level, and, again, concurrent with ongoing implement ation of higher EFT positions, so we're doing those things to continue to build the nursing workforce.

And, again, it's part of larger capacity to just, again, not just get that count more accurate so that we can, again, based on that count, be able to move towards those goals of shifting from, you know, making sure that we have a higher percentage of full time over part -time positions if that is what nurses want, but it's also the idea of, again, cons olidating and streamlining that data across the regions.

We need to work with all of the different groups involved, whether it's the unions, the nursing groups, it's the management at the RHAs, even in terms of the ITC equipment that's involved to make sur e that we're counting things the right way.

And when we start being able to do that I can say that that will actually help facilitate not just about creating more positions in that balanced way, but it's also going to be easier to share this information s o that the kinds of questions that the member asks will actually be better available just online so that it will save asking –having to have those questions because what would happen–what is happening is on September 28th we announced that we were enhancing transparency by making more key health statistical information online, make it available online. It was part of the international

October 22, 2015 LEGISLATIVE ASSEMBLY OF MANITOBA 2461 Right to Know Week and basically it's a case of, you know, we do believe that Manitobans deserve to have easy access to infor mation about how the health-care system is performing and we are committed to sharing as much detail as possible. And what it means is by making it available online it's accessible to everyone.

And it's going to include emergency medical services respons e times for rural Manitoba, such as information on how long an ambulance may take to arrive after a 911 call is placed from the within a particular community; and other information that will be posted online as it becomes available through this kind of consolidation process; and ensuring that we are using similar

definitions in terms of how we are counting these positions, will be everything from an archive of wait- time information for procedures such as hip and knee surgeries, and diagnostic tests such as MRI and CT scans; population counts including births and deaths; updates on how many people have been connected with a family doctor or a nurse practitioner through the Family Doctor Finder service; the number of visits that are made to our QuickCare clin ics across the province; as well as the prevalence of chronic illnesses such as hypertension and diabetes.

It will also include the number of hospitalizations for injuries. And, again, to the member's interest here, it will also indicate the numbers of physicians, nurses, and nurse practitioners that there are in the province. So the number of pediatric dental surgeries will also be included, the number of clients in home care, and the number of influenza immunizations, as well as data on pharmaceutical use.

So, again, we will get the details in this par - ticular case soon, but I can assure the member that we are getting the information compiled so that there will be a time in the near future where the very question that she is asking will be available no t just to her, but to other members of the public in an online format. Mrs. Driedger: I don't think I got an answer, there, Mr. Chair, to my question, and considering we're talking about right to know, I find that kind of ironic.

I'm understanding from that answer, though, that the government has backed away from their promise to increase full -time positions by the date on which they gave it. Having said that, I would ask the minister, what is the nursing shortage today? How many nurses are we short in Manitoba as of today? Ms. Blady: I know I did put a lot of information out there, but what I was trying to make clear to the member was the fact that, again, we do have numbers as of December 14.

I was trying to get –to explain to her that we are also, as a part of this right to know, clarifying the numbers that we do have because as the numbers are currently counted there are discrepancies within different

definitions between the RHAs. So, actually, in an endeavour to get her the best answers, and the clearest and most defined answers, it's about ensuring that we have consistency–that's what I was talking about –in data collection and in data management between the RHAs. So it was about saying that while we do have a very raw -number list of full -time nurses being just shy of 5,000 and part -time being over 6,500 as of December 14th, we know that that –obviously, time has passed, but, also, again, in terms of the counts and what are full - and part -time

definitions, those kinds of things, again, there is an ongoing commitment. I mean, clearly, our commitment is evident in that if we look at the numbers, again, and especially those numbers as they are reported by the College of Registered Nurses, the College of Registered Psychiatric Nurses, and the College of Licensed Practical Nurses, when we take a look at their numbers we can–it's clear that there is a commitment on our part to growing the complement of nurses, because every year from 1992 to 1999 their numbers indicated each year a drop in the nursing complement.

Each year it went down and, interestingly enough, as of 2000 and every year afterwards there has been an increase. And so, again, it's one of those things where, I believe, you know, the best year and, again, I'm trying to do the math here, but when the member opposite–when the best year her government has is a loss and our worst year was, again, of 11 nurses a nd that was factoring in a mass of retirements that occurred, again, I will put our worst year up against their best year any day.

And that goes with working collaboratively with the nurses' union. * (15:40) So, yes, we do have over seventeen, close to 1,800 active practising nurses. Again, we do have a number–but, again, take a look at those numbers. If we have seventeen –over, well, again, close to 1,800 active practising nurses, we know that in terms of nursing positions and other things available that

2462 LEGISLATIVE ASSEMBLY OF MANITOBA October 22, 2015 number that we have is about 11,500. So there are other nurses in the province. This is about getting a clear set of numbers and those clear set of numbers once the data is analyzed will not just be available to the member opposite but will be available to all Manitobans.

So we are clearly working with Manitoba nurses and all of the colleges within the nursing union, and, again, I look forward to being able to provide her with the clear numbers, but I know that, again, there's a lot of data analysis that will be involved because it is about working towards getting the numbers counted right, counted consistently across the province. Mrs. Driedger: I wonder if I could get a clear set of numbers of what the nursing shortage is today. I think the last nu mbers we saw, it was over 1,800 nurses that Manitoba was short and that would have been an April number, I believe.

I wonder if the minister could indicate an updated clear set of numbers. Ms. Blady: We'll endeavour to get the, again, the exact numbers to the member on that, and, again, as I was saying, we're going through and we are looking at how these positions are counted. One thing I can say is that since 2000 a total of 3,229 nurse positions and that includes RNs, RPNs and LPNs as well as nurse prac titioners have been created across the province. And the number of filled nurse positions has increased by over 2,432 over the same period, which is an increase of 27 per cent.

So, again, part of the increase in vacancies goes to the fact that we're actual ly increasing the number of positions available for nurses in the province, always looking to make sure that we have staffing options available throughout the province, and always looking forward to finding more nurses to fill those positions to better loo k after the communities that each of them choose to serve, whether they're communities that they're born and raised in or whether they choose to relocate to another part of the province.

It's about creating those opportunities, and that's why we have been increasing the nursing training seats, why we have been working with inter - nationally educated nurses and doing a variety of different things to grow the nursing population. And so much of that goes not just to the relationship that, again, that we have with the union but also with a variety of colleges in terms of how is it that we best grow our complement of nurses here.

And I think, again, the growth in 3,229 nursing positions is a clear indicator of, again, our desire to have a strong nursing workf orce, and always looking to have more nurses working here. I would much rather be in a situation of wanting to grow our nursing complement, growing our nursing complement and always needing maybe just one more, than having lineups of thousands of nurses looking for a job because they've all been handed pink slips, as has been done to many nurses in the past. Mrs.

Driedger: Well, just so that the minister isn't vague on how it works, her government handed out about 350 pink slips to nurses at –you know, fr om Morden-Winkler as Boundary Trails was formed and about 150 VON pink slips when they were changed. So, this government, even through the years , and I've been tracking some of that, have handed out hundreds and hundreds of pink slips too, so–that–just how the system works. So she may try to get political traction on it but I think she really needs to do a bit of homework here.

If we look at spending in health care, and it's certainly been raised as a concern across Canada in terms of sustainability of the funding levels that we have in Canada, I understand that the Department of Health here might have decided that they had some concerns around this issue too and have started to look at it a little bit more closely. Can the minister give us an update as t o the initiatives that are under – being undertaken in the department to address these concerns about sustainability of health-care funding? Ms.

Blady: I always look forward to the opportunity to talk about what it is that's being done to ensure health-care sustainability. The past couple of days have been excellent examples of that because today I was able to meet with the folks from DSM and they provided a wonderful example of exactly that kind of return on investment and creating a more sustainable system. Having moved one year ago to liquid- based cytology, we now have a system for the early and more accurate and more timely diagnosis of cervical cancer.

And what that means is that we have the opportunity there to reduce the number of unneeded retests down to 1 per cent of the 132,000 tests that are done every year. That's been, again, reduced. * (15:50) It's also been a case of–what was interesting was the DSM in taking direction from this government on

October 22, 2015 LEGISLATIVE ASSEMBLY OF MANITOBA 2463 how to, you know, to seek out those places where they could do things better –took it upon themselves to find ways that they could better serve, not just those that they were working with in terms of who they could provide diagnosis back to, us the patients, but they were able to, through savings, actuall y be able to acquire the system that they do have now. And we have a wonderful system that now, literally, on a space no larger than this table in front of me, is able to assess and provide slides of 48 patients at a time.

It refines the process in terms of the accuracy, of the sample taken. And so there is one great example of how they were able to not only improve the accuracy, the wait time, which again gets women to care faster or maybe tells them that they don't need care, that they're healthy; they are good. So they get to find out that they're healthy that much faster or they get to get onto the In Sixty patient journey faster. That–the savings there also are found in the fact that, again, there's fewer women having to return for retests.

There are, again, the costs associated with the retest, the cost associated with visiting a family doctor. Think about how many family doctor visits would be cancelled or unnecessary now, rendered unnecessary with the accuracy of this testing, there - fore allowing a n extra space now for a family practitioner to see a patient because they're no longer seeing a patient about an anomalous test result and testing them a second time. It's those kinds of things that involve sustainability. It's about providing– you can provide better care and you can provide more comprehensive care.

The cancer patient journey is another example of that, one of the things that we've learned over the past five years, and it's been so exciting, talking to the folks that put together and ran the model of the cancer patient journey for us and the learnings that we have from that, learnings that I look forward to applying to other places in the health -care system where, in providing better, more streamlined care, by providing navigators, they were actually able to find efficiency, to find ways of streamlining the system that made it much more cost effective, but also provided a higher quality of care.

And so it's been in everything from those aspects of, again, the, whether it's the testing that's been provided for folks, how that fits into the continuity of care within the in cancer patient, the In Sixty cancer patient journey. And one of the other things that was also remarkable was when we think about the amount of money that is saved and that creates sustainability in the system through vaccinations.

So now the fact that we are going to be vaccinating boys –that was actually another example of cost effectiveness, the what is best practice for vaccines for the HPV, the human papillomavirus, we've been able to change from a three -dose to a two -dose system.

In seeing that we were going to be saving money on only having to provide two doses now for girls in grade 6, we took up the opportunity to then go ahead and purchase vaccines for the boys becaus e effectively what's happening is the amount of money that we would have spent on three doses for the girls now covers the two doses needed for the girls, one dose for the boys, and only a little bit more needed to be spent. So there was an example of sci ence technology evidence -based and best -practice-based decision making where efficiencies were found.

And, again, what's most important about those vaccines is what they're going to save us in terms of, well, everything from I would say most importantly over any kind of dollar value, is peace of mind and a healthier population base.

We do have to take a sort of a larger perspective on population, health population because now we are going to have generations of kids from a particular age group on, certain cohorts, and we've seen this happen in other jurisdictions where not only is the incidents of cancer dropped and almost negated, but it's also other related infections associated with HPV have been eliminated–there's a huge cost savings there. So it's about in making those investments up front, that's where health sustainability comes in. That's why we're encouraging folks this year and every year to get the flu vaccine.

The fact that we've got a quadrivalent vaccine this year, the fact that it is now available in a nasal spray for kids aged –for the younger kids, the –I believe it's the two -to-17 range.

That means that the more folks that get that vaccine and the easier it is for parents to maybe take that needle-shy toddler or elementary school student to the pharmacy, the GP, to a flu clinic to get their flu vaccine now not –no longer through a needle, but through nasal spray, means that we are going to have more folks that are protected, and not only do they protect themselves, but we all know that through herd immunity, that getting a vaccine is not necessarily just about protecting yourself; it's about protecting those around you that may be immunocompromised, and as a cancer survivor I can tell you how important it is for having everyone around you to be vaccinated when you're immuno -

2464 LEGISLATIVE ASSEMBLY OF MANITOBA October 22, 2015 compromised. There are others that face that challenge as well. So a flu vaccine, getting a flu vaccine not just saves you the grief of having a flu, but it saves you the grief that might go with being away from work, the economic loss that you might face, the loss that we face to the entire system, but from a health sustainability system means that we can hopefully have fewer folks visiting emergency rooms, QuickCare clinics and their doctor's office. That's about sustainability.

So, yes, we've got a variety of things going on related to health -care sustainability, and those are just a few tangible aspects. It's about making up-front investments and, again, those investments matter, not just from a dollar perspective, but I think what matters most is the quality of care that they provide to people and the quality of life.

I have actually had, and it's an odd thing to say, but I actually got a message from a friend who thanked me for the fact that as a result of this she knows that her children will now –her sons and her daughters –will not face things like genital wart cervical cancer, penile cancer, that I've protected her kids from that. As a result, there's cost savings there, but, more importantly, there's a quality of life savings. So, again, these are the kinds of things that we're all working on and that we are working together with the DSM. We are also working with the doctors through the Choosing Wisely program.

The Choosing Wisely Manitoba is a phenomenal program that–and direction, and I really want to thank the DSM for what they have done. I was able to meet with them recently and discuss with them the work that they've done with physician engagement, because it's about making sure that our doctors do make the right call for diagnostic testing, that we are using our diagnostic resources most effectively. So I can say that health sustainability is about making wise investments. Mrs.

Driedger: Well, one of the wise investments, and it was certainly pointed out at vario us times today, would be the investment of a dedicated stroke unit. I mean, the minister was just talking about some of that in one hand and ignoring the dedicated stroke unit on the other hand. So she's a bit out of touch here and putting forward a lot of rhetoric without, perhaps, understanding all the things that can be done.

Now, I understand that there have been a couple of committees set up by the Department of Health and I understand that the deputy might have something to do with that and these committees have been struck because there is a concern about the sustainability of health-care funding. Can the minister indicate what the mandate of those committees are and whether there's one or two or three committees, and what is the mandate of these committees in terms of saving money or looking for cuts, or what is it that is the expectation of these committees that have recently been struck by the Department of Health? Ms.

Blady: Yes, again, wise investments are important and the committees that the member opposite references have been established and in–for a variety of reasons, and it's really been about not any kind of crisis concern over this health -care sustainability, but, in fact, about collaborative engagement and people knowing that if they get together, if they communicate and they build relationships they can do things better. So it's about being committed.

So that is why, for example, having used the example before, mentioned the idea of the mandates that we have with both the doctors and the nurses. * (16:00) It was about committing to work together to find additional ways of making the system sustainable but making the system sustainable because it's the best way of doing things and because they were looking for best practices and know ing that best practices were ways of, again, for example, through Choosing Wisely, ensuring that appropriate tests are being done as determined by the medical professionals and the professionals involved in analyzing those things.

We have also encouraged and seen phenomenal results in terms of lean initiatives which is govern - ment wide and health system wide and, again, have had the opportunity to talk to folks, whether it's been at–out in Selkirk about the results that they've seen out there. There are wo nderful learnings there from the Selkirk Mental Health Centre. We've also had a variety of programs that have won health initiative awards for the work that they've done because it's been about how is it that we empower folks on the front lines to make the best choices possible.

How is it that we transform the system, and how is it that we keep working together? And health- care sustain - ability goes from everything from, again, working with nurses and front -line folks about how they might organize everything from a storage cupboard to be able to best access resources, therefore making

October 22, 2015 LEGISLATIVE ASSEMBLY OF MANITOBA 2465 their workday earlier and what that does for the system. And it allows them time to actually be front-line providers more. It gives them more hours in their day to do that. We also have things that are higher level things like the Premier's (Mr. Selinger) Health Care Innovation Working Group and the work that is being done there in terms of pharmaceuticals. Again, what we've had happen with that group has been a national approac h to procuring drugs.

There's a phenomenal savings of money that occurs there when we are able to purchase together, especially as a province with a smaller population base. I mean, when you think about the fact that our population base isn't even a quarter of what it–of the population demographic of the GTA, that, again, for us to be able to work with our other provincial colleagues and to be able to, through the pan- Canadian Pharmaceutical Alliance, again, now we've got Quebec involved with that. The idea of us being able to bulk purchase, it's always about how we can do things better for Manitobans.

So it's really about getting the most bang for our buck, and I can say that we're doing that, and the kinds of things that I talked about earlier are great examples of that.

I can also say, as well, that when we have these kinds of groups and when we do work with folks–the member likes to think that I'm dismissive of a particular endeavour that she talked about today, but I've already spoken to the members of the, again, of the Heart and Stroke Foundation, and we did talk about, you know, there's a –there's clearly a difference between what an opposition can promise and what a government can deliver, and they know that what we can deliver to them, we're will ing to work with them on.

And so that there is a relationship there that we have with them, that we will continue to have with them, that we have had with them for a long time. She doesn't have to like that relationship. She doesn't have to agree with it. But I will continue to work with the folks from the Heart and Stroke Foundation. I will continue to take their advice, and we will see which direction that moves in because we do have a lot of shared goals with them.

And I just want to make sure, like wi th these other investments that I mentioned earlier, that we are doing them right, we're doing them in the best way for Manitobans and that we are doing them in a way that not only ensures that we get the best services for Manitobans, but that we are doing it in a cost- effective way. And so I am working with them to see how it is that we move forward to next steps. I can also add that we do have the information on the fast track that I can add, just was able to receive this from the Winnipeg Regional Healt h Authority.

And the Winnipeg Regional Health Authority emergency program advises that the streaming of patients occurs at Concordia, Grace, the Health Sciences Centre adult, Seven Oaks Hospital, Victoria and Misericordia hospitals, and in general, patients are assessed based on their Canadian Triage and Acuity Scale, their CTAS, and the MTA criteria. The high- acuity patients are assigned to the main emergency department, and the lower acuity patients are assigned to the minor treatment area.

The Health Sciences adults minor treatment area operates 24 -7, while the other emergency departments' minor treatment areas operate during peak emergency visit hours–emergency department visit hours. When fast -track or minor -treatment-area dedi - cated services are av ailable, we find that the length of stay is positively impacted for this patient group as well as impacting the larger patient population within the emergency department.

And, of course, we know that this impact is dependent on numerous factors including patient volumes, admitted patients and site activity related to patient acuity at any given period. So, as I said, I would get that answer to the member today or tomorrow, and I would like to thank those folks at the RHA that were able to ensure that they got that answer to us today for her previous question. Mrs. Driedger: The committees that have been struck to look at sustainability in the system, can the minister tell us how many times they've met? Ms.

Blady: In relationship to the member's question that she's asking about the exact meeting dates related to health -systems sustainability, I can assure her that when we think about –I'm not sure which particular group she's looking at because I do know that, for example, the DSM and physicians meet on a regular basis. I know that we are involved with, again, for example, the Health Care Innovation Working Group was established, you know, again, by the premiers in 2012, and there's, you know, regular meetings that occur on their part, and that has everything to do with the pan- Canadian pricing alliance.

2466 LEGISLATIVE ASSEMBLY OF MANITOBA October 22, 2015 So we have ongoing meetings that occur, again, within the premiers' –I guess, at the health -care innovation group. We have meetings that are occurring on an ongoing basis in terms of those –the work that is done with Doctors Manitoba, the doctors that–work that is done with the Manitoba Nurses Union. Again, I know that my deputy meets, and I meet, with the RHA chairs and CEOs on a regular basis. And so there –it's not about their –there's only one or two tables at which this is discussed.

This is something that is an ongoing series of discussions around a variety of tables and around every table on an ongoing basis. Committees are struck for a variety of reasons, and we try to get certain players at the table on a variety of issues. But to suggest that there is only one or two groups for whom there are meetings that occur and for whom that a small list of meetings could possibly be put together doesn't capture the sense of just how much this is being discussed around a variety of tables. So maybe if she would like to clarify, is there a particular table that she's looking at?

Because I can tell her that, literally, on a daily basis, some - body, somewhere is having a meeting where they're factoring into the equa tion how is it that they can make better choices, whether it's, again, through Choosing Wisely, whether it's through lean initiatives, whether it's through the regular meetings that occur relating to the pan- Canadian pharma- ceutical initiatives, those kinds of things.

So I know that there are –there's constantly meetings going, so if she can maybe clarify as to–if there's a particular table that she would like more information on, because I know we have a variety of tables where health -care sustainability is crucial.

In fact, yesterday, the regional health authorities had an education and subcommittee meeting where I know that that was part of the conversation that they were looking at: How is that in–that they can, again, better provide health-care services, both in terms of quality but also, again, in terms of ensuring that that quality health-care delivery is provided in a sustainable –a long-term sustainable way. * (16:10) Mrs. Driedger: Are any of these committees looking at length of stay in the WRHA acute -care hospitals?

And can the minister tell us if the length of stay in those hospitals is still the highest in Canada? I know a few years ago, it was climbing, and I understand that ou r length of stay was considered one of the highest in Canada, which certainly points to inefficiencies, also points to increase possibility of infection and creates some serious challenges in the health-care system. So two things: Can the minister tells u s what the WRHA length of stay is in this past fiscal year –the average length of stay, and if any of these committees are addressing how to handle that issue? Ms.

Blady: Again to earlier comments, in regards to the question put forward by the member opposi te, there seems to be broad reference to these committees and committees as to which –you know, is the committee looking at this or what–can it –does a committee have an answer, I guess I would just like some clarification as to which committees she might think have these answers, because, again, there are a variety of committees that meet throughout the entire health system.

So, to be able to provide an answer, I need greater clarity in her questions as, again, there are a variety of people that meet around a variety of tables as it relates to providing the best care for Manitobans and where conversations around health- care sustain- ability are part of their–again, their goals, their larger direction, and in–again, the idea of sustainability in the health -care system is one that is important, because, again, providing good quality care is what we're shooting for. It's what we all want, but you need to be able to do it over the long term.

So, again, if she could clarify which particular committee or table she thinks has that information. In regards to length of stay, you know, I guess while the RHAs will have work and records regarding length of stay, I always look at it through the filter of the patient. And so I want to make sure that when a patient is in a ho

Document details

Collection	Manitoba — Debates (Hansard)
Citation	40-4-70b
Type	hansard
Volume / chapter	40th 4th hansardpdf 70b.pdf
Language	en
Format	pdf
Source	PROVINCIAL
Identifier	291d1c460e3be55ef47b0c929c64a34296c2f3a9

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